Organization Active NPI

Breedlove Wound Care of Arkansas LLC

  • Family Medicine Physician
  • Batesville, AR
National Provider Identifier
1689569352
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BREEDLOVE WOUND CARE OF ARKANSAS LLC
Practice address
1415 N Saint Louis
Batesville, AR 72501-8467
Phone
(903) 947-2020
Fax
(903) 352-3665
NPI assigned
Jun 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elizabeth Ann BreedloveNPI 1982844213
Title
Owner
Phone
(903) 947-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1415 N Saint Louis
Batesville, AR 72501-8467

Mailing address

PO Box 1129
Tatum, TX 75691-1129
Phone (903) 947-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250702002345 AR Part B Supplier - Clinic/Group Practice 2466965397 Receives reassigned benefits from 2 practitioners
Practice locations: Batesville, AR

National Provider Directory

National Provider Directory

Locations

1415 N Saint Louis
Batesville, AR 72501
Phone (903) 947-2020

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1689569352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1129",
            "city": "TATUM",
            "state": "TX",
            "postal_code": "756911129",
            "telephone_number": "903-947-2020",
            "fax_number": "903-352-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N SAINT LOUIS",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725018467",
            "telephone_number": "903-947-2020",
            "fax_number": "903-352-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREEDLOVE WOUND CARE OF ARKANSAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "BREEDLOVE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-947-2020"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.